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SAN tO OOnue7P. <br /> COAIR POLLUTION CONTROL STRICT <br /> 1601 E. Hazelton 0. Box 2009, StocktonjWlifornia 95201 <br /> lephons: (209) 466-6781 <br /> plication for AUTHORITY TO CONSTRUCT and PERMIT TO OPERATE <br /> Date: .5 -\'� -qL Application Number: <br /> An application is required for each operation described in part B of instructions. <br /> 1. PERMIT TO BE ISSUED TOt Business license name of Corporation. Company, Individual <br /> Owner. Partner. or Governmental Agency. <br /> 2. HAILING ADDRESSs <br /> 3. ADDRESS AT WHICH THE EQUIPMENT IS TO BE OPERATEDt CITY r COUNTS <br /> 4. GENERAL NATURE OF BUSINESSs <br /> 5. EQUIPMENT DESCRIPTION: Pursuant to the provisions of the State Health and Safety <br /> Coda and the Rules and Regulations of the San Joaquin County Air Pollution Control <br /> Districts application is hereby sada for PERMIT TO OPERATE the following equipments <br /> �c3x� w<AN' QhGs� Z ani <br /> P�u ';� vQ�cr re�ever�. F ct`, o �hea�o� Ccs c�e1 sy ;dem <br /> lffx <br /> Continue on additional 8h x 11 page if • ace above is insufficient. <br /> 6. TYPE AND ESTIMATED COST OF BASIC EQUIPMENTt <br /> Go <br /> 7. TYPE AND ESTIMATED COST OF AIR POLLUTION CONTROL EQUIPMENT: <br /> � iCOC •OL <br /> 8. SIGNATURE OF APPLICANTS TITLE OF SIGHERs <br /> 9. TYPE OR PRINT NAME OF SIGNERt <br /> NAME t C\auAyU S TELEPHONE NO. 1 Z <br /> Validation (A.P.C.D.) use only <br /> Data Application Receivedt Fee Schedule Humbert <br /> .5 _ rtFiling Feet$ - o %U Permit het$ <br /> pn n1 nn nom.. 1 /-.. _ _ <br />